Neoadjuvant chemoradiotherapy, chemotherapy, and radiotherapy do not significantly increase the incidence of anastomotic leakage after esophageal cancer surgery: a meta-analysis

Jin, Zixian; Zhang, Jian; Chen, Dong; Wu, Sikai; Xue, Penglai; Zhu, Kanghao; Xu, Congcong; Zhu, Chengchu; Zhang, Bo

doi:10.1093/dote/doab089

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…Therefore, it is very important to accurately evaluate the preoperative staging of patients. For esophageal cancer patients, accurate preoperative staging is helpful to provide the most appropriate individualized treatment plan for these patients (6)(7)(8)(9)(10). For example, some patients with preoperative stage T4 can increase the chance of radical resection through neoadjuvant therapy (11,12).…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of endoscopic ultrasonography in staging diagnosis of esophageal cancer after neoadjuvant radiotherapy and chemotherapy

Li¹,

Wang²,

Kang³

et al. 2022

J Gastrointest Oncol

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Background: Clinically, it is necessary to evaluate the overall situation of the tumor before treatment, understand the disease stage of the patient, and choose the most reasonable treatment plan. Therefore, it is necessary to seek an efficient and accurate staging diagnosis method. EUS is widely used in staging esophageal cancer, but its accuracy will be affected by the experience of endoscopic diagnosis physicians.

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Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of endoscopic ultrasonography in staging diagnosis of esophageal cancer after neoadjuvant radiotherapy and chemotherapy

Li¹,

Wang²,

Kang³

et al. 2022

J Gastrointest Oncol

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“…Postoperative complications have always been an area of concern in EC. Jin et al ( 28 ) found in a meta-analysis that nCRT and neoadjuvant radiotherapy (NRT) did not significantly increase the risk of postoperative anastomotic leak in EC patients. nCRT has attracted a great deal of attention.…”

Section: Definition and Progress Of Neoadjuvant Therapy For Esophagea...mentioning

confidence: 99%

Surgical intervention after neoadjuvant therapy in esophageal cancer: a narrative review

Ke¹,

Xie²,

Liang³

et al. 2023

J Thorac Dis

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Background and Objective Esophageal cancer is one of the common malignant tumors in China. Previous studies have shown that surgery alone is less effective. Neoadjuvant therapy refers to preoperative chemoradiotherapy, which is the standard treatment for locally advanced and operable esophageal cancer. Selection of appropriate surgical methods and timing after neoadjuvant therapy is of great significance for improving the prognosis of patients and reducing postoperative complications. Methods An online electronic search of all eligible literature through PubMed, Google Scholar, and the Cochrane Library database was conducted using a combination of the following keywords: esophageal cancer, neoadjuvant therapy, neoadjuvant chemotherapy, chemoradiotherapy, immunotherapy, targeting, surgery, complications. With a focus on the use of surgery after neoadjuvant therapy, Eligible articles were identified by one or both authors. Key Content and Findings Neoadjuvant chemoradiotherapy combined with radical surgical resection remains the current standard of care for resectable esophageal cancer, significantly improving survival and pathologic complete response (PCR) compared with preoperative chemotherapy Recently, studies have also found that immunotherapy combined with chemotherapy has a more advantageous pathological response in patients with locally advanced disease. Although the emergence of targeted drugs has led to a change in treatment mode from traditional chemoradiotherapy to precision therapy, the postoperative progression-free survival (PFS) and overall survival (OS) need to be explored as well as how surgery-related risks caused by treatment can be reduced. Traditionally, surgery is performed 4–6 weeks after neoadjuvant therapy, and optimal timing for surgery after treatment is still being explored as research progresses, the surgical method also should be determined according to the specific situation of the patient. Postoperative complications should be dealt with in a timely manner, and of course, active preoperative intervention is equally important. Conclusions Neoadjuvant therapy combined with surgery is the gold standard for resectable esophageal cancer. However, optimal timing of surgery after preoperative treatment remains unclear. Minimally invasive thoracoscopic surgery (including robotic surgery) has gradually replaced traditional open surgery. Active prevention before operation, accurate and meticulous operation during operation, and timely treatment after operation can minimize the incidence of adverse events.

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“…Some studies indicated that neoadjuvant chemotherapy, particularly in combination with radiotherapy, is associated with increased surgical complication risk in patients with oesophageal cancer undergoing resection surgery. However, a meta-analysis of 17 randomised controlled trial (RCT)s, including more than 2800 patients, determined that neither neoadjuvant chemotherapy nor chemoradiotherapy were associated with increased risk of anastomotic leakage, a complication of particular concern among surgeons performing oesophageal resection surgery [32]. Other studies have drawn specific attention to increased incidence of pulmonary complications and vocal cord paralysis, although data from a second meta-analysis of 18 studies failed to demonstrate any statistically significant increase in risk for any of the included complications [33].…”

Section: Neoadjuvant Chemotherapy: Is There Significant Risk?mentioning

confidence: 99%

Patients Undergoing Systemic Anti-Cancer Therapy Who Require Surgical Intervention: What Surgeons Need to Know

Robinson

McNamara

Clouston

et al. 2023

Cancers

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As part of routine cancer care, patients may undergo elective surgery with the aim of long-term cure. Some of these patients will receive systemic anti-cancer therapy (SACT) in the neoadjuvant and adjuvant settings. The majority of patients, usually with locally advanced or metastatic disease, will receive SACT with palliative intent. These treatment options are expanding beyond traditional chemotherapy to include targeted therapies, immunotherapy, hormone therapy, radionuclide therapy and gene therapy. During treatment, some patients will require surgical intervention on an urgent or emergency basis. This narrative review examined the evidence base for SACT-associated surgical risk and the precautions that a surgical team should consider in patients undergoing SACT.

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Neoadjuvant chemoradiotherapy, chemotherapy, and radiotherapy do not significantly increase the incidence of anastomotic leakage after esophageal cancer surgery: a meta-analysis

Cited by 4 publications

References 45 publications

Systematic review and meta-analysis of endoscopic ultrasonography in staging diagnosis of esophageal cancer after neoadjuvant radiotherapy and chemotherapy

Systematic review and meta-analysis of endoscopic ultrasonography in staging diagnosis of esophageal cancer after neoadjuvant radiotherapy and chemotherapy

Surgical intervention after neoadjuvant therapy in esophageal cancer: a narrative review

Patients Undergoing Systemic Anti-Cancer Therapy Who Require Surgical Intervention: What Surgeons Need to Know

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